The death of a newborn baby at a Fort Mill birthing center in January was a homicide, a York County jury ruled Thursday in a coroner’s inquest.
Daxton Lee Green died Jan. 20 shortly after being born at the Carolina Community Maternity Center in Fort Mill. A preliminary autopsy showed no signs of trauma on the baby, but York County Coroner Sabrina Gast on Thursday convened a jury to determine the manner of the boy’s death.
The jury had four options in ruling the manner of death – undetermined, natural, homicide and accidental.
“Homicide in this particular case is not a legal definition; it’s a description of the manner of death,” Gast said after Thursday’s verdict. “They felt like there was enough information in the testimony today and the documents provided to them that at some level, there was a responsible party for the death of Daxton.”
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There’s been no criminal investigation into Daxton’s death, and Gast said she doesn’t foresee any further action. After the newborn died, her office conducted a death report along with the York County Sheriff’s Office, the 16th Circuit Solicitor’s Office and the State Law Enforcement Division’s child task force.
“We came to the conclusion there wasn’t anything that would rise to the criminal level,” she said.
Daxton’s parents, Ryan and Megan Green, were in the courtroom Thursday but were not available for comment after the verdict. Megan Green left the courtroom in tears earlier when a pathologist testified about the autopsy on her son.
The newborn’s cause of death was meconium aspiration, according to Dr. Craig Hart of York Pathology Associates. He told jurors that meconium, or the first stool from an infant, was around the fetus in the uterus and was also in the newborn’s stomach and airway.
“Generally, it’s attempted to suction that at birth and get that meconium secretion out so they can get adequate air in,” he said.
Dr. David Fisher, of Levine Children’s Hospital in Charlotte, wasn’t involved in Megan Green’s pregnancy but testified about meconium aspiration, which he said typically doesn’t happen unless a fetus is “in distress.”
“If a child has meconium aspiration, that’s a sign that child was not only in trouble but was near death,” he said. “In today’s world, we don’t see meconium aspiration hardly ever anymore.”
Fisher said it’s possible to recover a child from meconium aspiration, but that it requires “the right transition, the right technical support.” He added that there’s no “tell tale” signs of meconium aspiration, and that it’s usually not evident until after the water breaks.
The midwives who testified Thursday said they began CPR on Daxton, gave him oxygen and used a bulb syringe to try to suction out the meconium from the baby’s mouth, but Fisher said that could push the meconium further into the newborn’s airway.
Christine Strothers, the midwife who oversaw Green’s pregnancy, told jurors she didn’t see signs of meconium until the baby was crowning. When she tried to get the umbilical cord from around the baby’s neck, the baby’s body started coming out, and that’s when she saw the meconium.
Shortly after Daxton was born, the midwives called 911. Paramedic Thomas Burdette said the newborn was still attached to his mother by the umbilical cord when paramedics arrived. He decided there wasn’t enough time to get a gurney after clamping and cutting the cord, and carried Daxton to the ambulance in his arms.
Burdette said they tried twice to intubate the newborn, but the meconium fluid kept getting into the tube.
Ryan Green, who was in the birthing room throughout the delivery, testified that a “sense of urgency” increased in the delivery room after the baby crowned.
“They talked to us a little less and talked to each other a little more,” he said of the birthing center employees. He recalled they retrieved a manual resuscitator right before his son was born.
“You could tell right away he was very limp, very lifeless,” Ryan Green said.
Green rode in the cab of the ambulance to Carolinas Medical Center-Pineville, where eight to 12 emergency personnel worked on his son.
“As soon as I got in the room, the doctor introduced himself to me and said ‘There’s nothing we can do,’ ” Green said. “He mentioned that he felt if the birth was in a hospital, that they would have been able to identify the issues earlier and get them taken care of.”
Regulations from the S.C. Department of Health and Environmental Control dictate that expecting mothers cannot receive care from midwives or birthing centers if their pregnancy is classified as high-risk, and they are required to undergo a risk assessment with a physician before receiving care from a birthing center. A physician who examined Megan Green twice, including in December before Daxton’s birth, said she and Daxton appeared to be in good health.
Strothers said she saw Green monthly until the final weeks of the pregnancy, when she saw her more frequently.
“She had a very straight-forward pregnancy,” Strothers said of Green. “She didn’t have problems with blood pressure or swelling – any of the things we look for possibly being things that could signal a problem during pregnancy.”
Jurors also heard testimony from Michell Hatcher of DHEC, who explained the licensing requirements for midwives and birthing centers, and the process of reviewing centers after an infant death.
Hatcher said DHEC found two violations at the Fort Mill center after Daxton’s death, including Strothers’ not consulting with a physician before administering pitocin to Green for a retained placenta, which isn’t the intended use for the drug.
The birthing center’s website indicates the last birth at the facility was Feb. 28. It had previously been shut down in 2013 after the death of another baby there.
DHEC issued an emergency suspension order for the center in September 2013, citing “various violations of the law.” That order followed an August 2013 incident during which a baby was delivered with no heartbeat, after the center failed to contact a physician at numerous points during labor. The order also cited the center for previously failing to have a physician on call at all times, as mandated by state law.
The center and DHEC resolved the issues listed in the emergency order, which was lifted in February 2014. A DHEC spokesman said earlier this week that the center is no longer licensed with the state.
A Rock Hill couple last year filed a wrongful death lawsuit against the center involving another baby. Lee and Katherine Wagner allege the staff at the center provided inadequate care during Katherine Wagner’s pregnancy with their daughter, Stacy, who was later stillborn at a hospital after Wagner first went to the center experiencing painful contractions.
Teddy Kulmala • 803-329-4082